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Radiological and serological predictors of cavitary transformation in rheumatoid arthritis-associated pulmonary nodules: a retrospective cohort study

  • 0Department of Rheumatology, Faculty of Medicine, Firat University, University Neighbourhood, Yahya Kemal Street No:25, 23200, Centre, Elazig, Türkiye. boz@firat.edu.tr.
Clinical Rheumatology +

|

July 18, 2025

|

July 18, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Cavitary pulmonary nodules (CPN) in rheumatoid arthritis (RA) are predicted by larger nodule size and positive autoantibodies. An 18 mm nodule diameter cutoff effectively identifies these transformations in RA patients with pulmonary nodules (PN).

Area Of Science

  • Rheumatology
  • Pulmonology
  • Radiology

Background

  • Cavitary pulmonary nodules (CPN) are a rare but significant manifestation of rheumatoid arthritis (RA).
  • Predictors for CPN in RA patients with pulmonary nodules (PN) are not well-defined.
  • This study investigates clinical, immunological, and imaging features associated with CPN in RA.

Purpose Of The Study

  • To identify key predictors of cavitary transformation in RA-associated pulmonary nodules.
  • To determine the association between radiological features, autoantibody status, and CPN development.
  • To evaluate the diagnostic performance of nodule size in predicting cavitation.

Main Methods

  • Retrospective cohort study of 156 RA patients with PN on CT scans (2010-2024).
  • Comparison of clinical, autoantibody, treatment, and radiological data between patients with and without CPN.
  • Statistical analysis including logistic regression and ROC analysis to identify predictors and optimal cutoffs.

Main Results

  • CPN occurred in 9% of RA patients with PN.
  • Patients with CPN had more numerous and larger nodules, with higher positivity for rheumatoid factor, anti-CCP antibodies, and ANCA.
  • Largest nodule diameter was the sole independent predictor of cavitation (OR 1.59), with an 18 mm cutoff showing high discriminative power (AUC 0.979).

Conclusions

  • Nodule size and autoantibody positivity are key correlates of cavitary transformation in RA-associated PN.
  • Imaging-based risk stratification using nodule diameter is supported.
  • Prospective validation in broader RA populations is recommended.

Keywords:

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